Paratonsillar abscess of tonsils is called the most severe, the last stage of inflammation in the pharynx, which is characterized by the formation of a cavity filled with pus. This disease has medical synonyms - phlegm tonsillitis and acute paratonsillitis.
This disease is equally common in both adults and children. It is characterized by the presence of relapse, if predisposing factors remain.
What actually happens in the body? First, local protection is triggered, a limited focus of the inflammatory process is formed in response to infection. Gradually, the process is complicated by abscess formation of tonsil tissue and purulent fusion.
In this case, a near-tonsillar abscess is formed, which can have several localizations in the tissue surrounding the tonsils:
- with front-upper arrangement;
- external or lateral arrangement;
- back localization;
- purulent fusion in the lower sections.
What is the reason?
The causes of the disease
The main reason for the appearance of a cavity with pus in the pharynx is the ingress of pathogenic bacteria and other microorganisms (staphylococci, protea, Escherichia coli, streptococci, Klebsiella and others) into those tissues that surround the tonsils. Usually this abscess is not an independent disease, rather it is a complication of other inflammatory processes that are present in the oral cavity or pharynx.
Predisposing factors of tonsil abscess may be as follows:
- Diseases of the pharynx caused by bacteria. Often an abscess around the tonsils occurs as a complication of severe tonsillitis, tonsillitis or pharyngitis. Especially if these diseases are untreated or have been ignored. Pathogenic flora actively multiplies if it is not suppressed by medications, while it spreads to all tissues of the pharynx, oral cavity and even descends into the respiratory tract.
- Diseases of the gums and teeth can also provoke the appearance of an abscess. Damage to tooth enamel, gums, long-untreated carious teeth, chronic periodontal disease contribute to the appearance of a constant focus of infection. At the same time, pathogenic microflora spreads to the tonsils and other tissues. With reduced immunity, these bacteria cause an abscess.
- Throat injuries. Damage to the mucous membrane of the throat, through which pathogens enter deeply located tissues, can also cause paratonsillar abscess. Often these are accidental injuries resulting from incorrect diagnostic tests, such as gastro- or bronchoscopy, biopsy, etc.
- The development of this abscess is often observed in people prone to chronic tonsillitis, taking antibiotics for a long time, and having weakened immunity.
Tonsil abscess formation process
As already mentioned, often an abscess of this type is formed against a background of chronic tonsillitis. Initially, deep pits appear on the surface of the tonsils, and against the background of inflammatory processes, scars form in their area. They also appear on the palatine arches. This leads to a fusion of these tissues with the capsule of the tonsil.
Then, during the next exacerbation of tonsillitis, the following happens: the pathological masses do not allow the tonsils to drain normally, they are not cleaned of the waste products of microorganisms, of mucus - and all this becomes a breeding ground for the propagation of pathogenic microflora. The infection penetrates deep into the fiber and becomes the cause of the cavity, accumulating pus.
A photo of tonsil abscess is presented above.
Types of pathology
The formation of an abscess has several stages. The initial stage (stage of edema) is characterized by swelling of the tissues around the tonsils, but so far they are weakly expressed, and therefore the patient may not notice the process.
At the stage of infiltrate formation, hyperemia joins the edema, the patient may feel pain when swallowing and discomfort in the throat. There is an increase in local temperature due to increased blood flow to the tissues.
The formation stage of tonsil abscess, which develops on the fifth day after the onset of the disease, is characterized by the formation of a cavity in which pus accumulates. The pharynx upon examination shows a pronounced deformation due to protrusion of the abscess. The patient experiences severe pain, opening the mouth is difficult and causes an increase in pain.
Symptoms of abscess around tonsils
Symptoms of this disease occur unexpectedly, it is characterized by an acute onset. First of all, it is:
- severe pain in the throat, usually one-sided .; pains increase and reach the point at which the patient cannot swallow saliva;
- increase in body temperature up to 39.5 degrees;
- pain radiates to the ear and temple from the formation of an abscess;
- the patient feels severe weakness;
- the patient's body shows the presence of intoxication - chills, tremor of the extremities, headache, darkening in the eyes;
- insomnia or increased drowsiness;
- sharp pain and enlarged cervical lymph nodes;
- increased saliva formation (hypersalivation);
- thick white coating on the tongue;
- neck pain when turning the head;
- severe bad breath.
Symptoms of tonsil abscess are very unpleasant.
Often on the seventh day, if treatment does not occur, the abscess opens itself, which is accompanied by a relief of the patient's condition and a slight decrease in pain symptoms. But serious complications are possible, such as neck phlegmon, mediastinitis, meningitis, encephalitis, brain abscess, etc.
At the slightest suspicion of an abscess of tonsils, you must immediately consult a doctor!
Treatment of acute paratonsillitis
This disease is treated exclusively in a hospital, i.e. the patient is hospitalized. Therapy of acute paratonsillitis is both medical and surgical.
Treatment of tonsil abscess should be timely.
The patient is prescribed antibiotics, usually medications with a wide spectrum of action, effective in the presence of gram-positive and gram-negative microflora. It can be aminopenicillins, lincosamides or cephalosporins. Antibiotics are usually given in the form of injections. Intramuscular or intravenous is an envy of the form of inflammation, as well as the severity of the patient's condition.
Of the symptomatic treatment, the patient is given antipyretic drugs, painkillers and antiseptic gargles.
Tonsil abscess removal
In what cases may this be required? Surgical treatment involves opening the tonsil abscess and subsequent drainage. This operation is done under general anesthesia, therefore it is painless for the patient. Then, after the surgery and change of inpatient treatment to outpatient treatment, the patient receives detailed instructions on what to do to heal the wound surface as soon as possible and to prevent recurrence of the purulent cavity around the tonsils. If drainage during surgery was insufficient, then the patient will be re-cleaned of the purulent cavity. If the abscess occurs again and again, then the affected tonsil is removed by surgery.
Relapse prevention of acute paratonzillitis
With proper treatment, recovery should occur within two weeks after the operation. But in the case of perforation of the pharyngeal wall and the exit of pus to the mediastinum, and even more so to the cranial cavity, the forecasts are extremely threatening.
Conclusion
To avoid a recurrence of this disease, you need to pay increased attention to your health. Timely treat carious teeth, pharyngitis, prevent the presence of chronic pathologies in the throat. It is important to increase immunity in all available ways, such as proper nutrition, regular light exercise, taking vitamins, etc.